title: Comparative study of trochanteric fracture treated with the proximal femoral nail anti-rotation and the third generation of gamma nail.
abstract: OBJECTIVE
  To compare the results between the proximal femoral nail anti-rotation (PFNA) and the third generation gamma nail (TGN) in the treatment of trochanteric fractures.
  
  
  METHODS
  Between April 2007 and May 2008, 107 consecutive patients older than 60 years with trochanteric femoral fractures were treated with PFNA or TGN. The preoperative variables including patient age, gender, fracture classification, walking ability and American Society of Anaesthesiologists (ASA) rating of operative risk were summarised. Operative time, fluoroscopy time, blood loss, and any intra-operative complication were recorded for each patient. Follow-up was undertaken at 3, 6, and 12 postoperative months, and yearly thereafter. Plain AP and lateral radiographs were obtained at all visits. All changes in the position of the implant, complications, or fixation failure were recorded. Hip range of motion, pain about the hip and the thigh, walking ability score and return to work status were used to compare the outcomes.
  
  
  RESULTS
  There were 55 patients in the PFNA group and 52 in the TGN group. The two groups were comparable with regard to the preoperative variables. The mean follow-up time was 17.5 months (range 12–24). Patients treated with a PFNA experienced a shorter fluoroscopy time and less blood loss. Sixteen patients were lost during the follow-up period. All the other fractures were radiographically healed at the last visit. There were no significant differences between the groups in terms of functional outcomes, hospital stay, intra-operative and postoperative complications.
  
  
  CONCLUSIONS
  PFNA provides less blood loss and shorter fluoroscopy time but no advantages in functional outcome, intra-operative and postoperative complications when compared with TGN. These two implants were comparable in the treatment of trochanteric fractures.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, Jiangsu 215006, China. xuyaozeng@163.com
authors.forename: Xu
authors.initials: X
authors.lastname: Yaozeng
authors.forename: Geng
authors.initials: G
authors.lastname: Dechun
authors.forename: Yang
authors.initials: Y
authors.lastname: Huilin
authors.forename: Zhu
authors.initials: Z
authors.lastname: Guangming
authors.forename: Wang
authors.initials: W
authors.lastname: Xianbin
mesh_terms: D000368:Aged; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods*; D006620:Hip Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012399:Rotation; D016896:Treatment Outcome